Kristina Louise Ellis, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

204589 Issued in AK

Practice address

4100 Lake Otis Pkwy Ste 320
Anchorage, AK 99508-5231

Phone

(907) 563-4810

Fax

(907) 563-4811

NPI assigned

Jun 2, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Peak Neurology and Sleep Medicine, LLCGroup PAC ID 6901024017, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

Merit-based Incentive Payment System (MIPS)

Final score

70.59 of 100Reported as group

Quality

83.37

Promoting interoperability

100

Improvement activities

40

Cost

16.65

Merit-based Incentive Payment System (MIPS)

Final score

88.88 of 100Reported as apm

Quality

71.03

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kristina.ellis.1@10055.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peak Neurology and Sleep Medicine, LLC

  • Multi-Specialty Clinic/Center
  • Anchorage, AK
  • NPI 1194130823
  Medicare reassignment Care Compare group
• Coastal Neurology and Neurosurgery, Inc

  • Neurological Surgery Physician
  • Anchorage, AK
  • NPI 1689927626
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1104440585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085231",
            "telephone_number": "907-563-4810",
            "fax_number": "907-563-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY STE 320",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085231",
            "telephone_number": "907-563-4810",
            "fax_number": "907-563-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KRISTINA",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AK",
            "license": "204589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Leigh Ellis, M.S., CCC-SLP
• Christopher Kyle Ellis
• Deketria Ellis
• Jermaine Shanin Ellis
• Jess Taylor Ellis, DDS, MS
• Richard A Ellis, PA
• Adam Covino Ellison, M.D.
• Robert Andrew Ellison, REGISTERED NURSE
• Stephen C Ellison, MD
• Laura Ellsworth

• Surgical Physician Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Surgical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.